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Figure Legends

Figure. 1

Flow chart of patient assessment.

Figure. 2

Flow chart of the study participants.

Figure. 3

Receiver operating characteristic analysis for handgrip strength. AUC: area under

the curve; CI: confidence interval.

29

Table 1 Baseline clinical characteristics of the low and high health literacy groups.

Total

Low HL

High HL

t or χ2

p Value

(n=167)

(n=90)

(n=77)

value

70.5 ± 12.8

73.4 ± 12.8

67.1 ± 12.1

3.27

< 0.01

124 (74)

66 (73)

58 (75)

0.01

0.86

23.8 ± 4.4

22.9 ± 4.4

24.9 ± 4.3

2.93

< 0.01

No

62 (37)

35 (39)

27 (35)

0.27

0.88

Past

71 (43)

37 (41)

34 (44)

Current

34 (20)

18 (20)

16 (21)

89 (53)

41 (46)

48 (62)

4.05

0.04

No

17 (10)

9 (10)

8 (10)

6.42

0.04

Ex

31 (19)

23 (26)

8 (10)

Yes

119 (71)

58 (64)

61 (79)

132 (79)

65 (72)

67 (87)

4.62

0.02

18.9 ± 11.4

19.5 ± 11.8

18.2 ± 11.0

0.72

0.47

Age, years

Male ratio, n (%)

BMI, kg/m²

Smoking, n (%)

Employment, n (%)

Marriage, n (%)

Living together (%)

Admission duration,

days

Comorbidities, n (%)

Hypertension

110 (66)

59 (66)

51 (66)

1.00

Diabetes

54 (32)

32 (36)

22 (29)

0.63

0.41

Dyslipidemia

98 (59)

49 (54)

49 (64)

1.09

0.27

79 (47)

53 (59)

26 (34)

9.52

< 0.01

Arrhythmia

68 (41)

42 (47)

26 (34)

2.86

0.09

Renal dysfunction

41 (25)

27 (30)

14 (18)

2.52

0.10

Stroke

22 (13)

18 (20)

4 (5)

< 0.01

Chronic lung disease

19 (11)

10 (11)

9 (12)

< 0.01

1.00

Locomotive disease

28 (17)

19 (21)

9 (12)

2.01

0.15

2.36 ± 2.01

2.76 ± 1.95

1.90 ± 1.99

2.81

< 0.01

Hemoglobin, g/dL

13.1 ± 2.38

12.6 ± 2.5

13.7 ± 2.1

3.12

< 0.01

Albumin, g/dL

3.71 ± 0.49

4.0 ± 0.5

3.8 ± 0.5

0.68

0.50

WBC, ×109/L

68.7 ± 46.8

66.9 ± 35.2

70.9 ± 57.9

0.55

0.59

BNP, pg/mL

494 ± 651

564 ± 622

411 ± 682

1.51

0.13

eGFR, mL/min/1.73m2

53.9 ± 22.6

50.8 ± 25.1

57.5 ± 18.9

1.92

0.06

GNRI

100.5 ± 11.8

98.4 ± 11.4

103.0 ± 12.0

2.50

0.01

Congestive heart

failure

Charlson Comorbidity

Index

Medications, n (%)

Beta blocker

121 (72)

64 (71)

57 (74)

0.06

0.73

ARB

52 (31)

25 (28)

27 (35)

0.72

0.32

ACE-I

51 (30)

22 (23)

31 (39)

4.07

0.04

Diuretic

99 (59)

58 (64)

41 (53)

1.72

0.16

Nitric acid

20 (12)

11 (12)

9 (12)

< 0.01

1.00

Ca antagonist

39 (23)

29 (32)

10 (13)

7.54

< 0.01

Statin

101 (60)

46 (51)

55 (71)

6.34

0.01

Functional

20.1 ± 4.4

18.0 ± 4.3

22.6 ± 3.0

6.97

< 0.01

Communicative

16.3 ± 4.7

13.3 ± 3.9

19.8 ± 2.5

12.5

< 0.01

Critical

11.4 ± 3.5

9.7 ± 3.2

13.4 ± 2.7

7.11

< 0.01

Total

47.7 ± 9.3

40.9 ± 6.6

55.7 ± 4.0

17.2

< 0.01

Handgrip strength, kgf

28.1 ± 11.1

24.8 ± 9.8

31.9 ± 11.3

3.99

< 0.01

SPPB total, points

10.6 ± 2.1

10.1 ± 2.3

11.2 ± 1.6

3.32

< 0.01

Balance test, points

3.72 ± 0.71

3.60 ± 0.86

3.85 ± 0.48

2.34

0.02

Gait speed, m/s

0.91 ± 0.28

0.82 ± 0.27

1.0 ± 0.3

2.13

< 0.01

5-Chair stand test, sec

10.4 ± 5.2

11.2 ± 4.9

9.4 ± 5.5

2.15

0.03

14-items HLS, points

ACE-I: angiotensin converting enzyme inhibitor; ARB: angiotensin II receptor blocker; BMI:

body mass index; BNP: brain natriuretic peptide; eGFR: estimated glomerular filtration rate;

GNRI: Geriatric Nutritional Risk Index; HL: health literacy; SPPB: Short Physical Performance

Battery; WBC: white blood cell; 14-items HLS: 14-items Health literacy scale.

Table 2

Correlation coefficient test between health literacy and handgrip strength (n =

167)

Health literacy

Correlation coefficient

p-value

Functional

0.28 (0.14- 0.42)

< 0.01

Communicative

0.23 (0.09- 0.37)

< 0.01

Critical

0.19 (0.04- 0.33)

0.01

Total

0.32 (0.18- 0.45)

<0.01

Table 3

Multiple linear regression test for handgrip

Univariate model

Multivariate model

Variable

β (95% CI)

p value

β (95% CI)

p value

Age

-0.57 (-0.67- -0.47)

< 0.01

-0.29 (-0.39- -0.19)

< 0.01

Sex

16.6 (13.7- 19.5)

< 0.01

11.7 (9.09- 14.4)

< 0.01

BMI

1.15 (0.82 - 1.49)

< 0.01

0.05 (-0.31- 0.41)

0.78

Disease code

1.67 (0.45- 2.88)

< 0.01

0.30 (-0.46- 1.06)

0.43

Congestive heart failure

-8.58 (-11.7- -5.44)

< 0.01

-2.75 (-5.30- -0.20)

0.03

Stroke

-6.06 (-11.0- -1.12)

0.02

-1.83 (-4.91- 1.25)

0.24

Charlson Comorbidity Index

-1.90 (-2.70- -1.11)

< 0.01

-0.06 (-0.70- 0.58)

0.86

GNRI

0.49 (0.36- 0.61)

< 0.01

0.11 (-0.02- 0.25)

0.10

Smoking

11.1 (8.02- 14.2)

< 0.01

0.38 (-2.06- 2.83)

0.76

14-Item health literacy scale

0.39 (0.21- 0.56)

< 0.01

0.118 (0.07- 0.23)

0.04

β: standardized partial regression coefficient; BMI: body mass index; BNP: brain natriuretic peptide; CI:

confidence interval; eGFR: estimated glomerular filtration rate; GNRI: Geriatric Nutritional Risk Index

...